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Treatments and drugs
By Mayo Clinic staffTreatment for mild cases mainly consists of:
- Bed rest
- Plenty of fluids
- Anti-inflammatory drugs — such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin, others) and naproxen (Aleve, others) — to relieve headaches and fever.
Antiviral drugs
More-serious cases of encephalitis usually require aggressive antiviral treatments. Antiviral drugs commonly used to treat encephalitis include:
- Acyclovir (Zovirax)
- Ganciclovir (Cytovene)
Some viruses, such as insect-borne viruses, don't respond to these treatments. However, because the specific virus causing the infection may not be identified immediately or at all, treatment with acyclovir is often begun immediately. This drug can be effective against the herpes simplex virus, which can result in significant complications or death when not treated promptly.
Side effects of the antiviral drugs may include nausea, vomiting, diarrhea, loss of appetite, and muscle or joint soreness or pain. Rare serious problems may include abnormalities in kidney or liver function or suppression of bone marrow activity. Appropriate tests are used to monitor for serious adverse effects.
Supportive care
Additional supportive care also is needed in the hospital for people with severe encephalitis. The care may include:
- Breathing assistance, as well as careful monitoring of breathing and heart function
- Intravenous fluids to ensure proper hydration and appropriate levels of essential minerals
- Anti-inflammatory drugs, such as corticosteroids, to help reduce swelling and pressure within the skull
- Anticonvulsant medications, such as phenytoin (Dilantin), to stop or prevent seizures.
Follow-up therapy
After the initial illness, it may be necessary to receive additional therapy depending on the type and severity of complications. This therapy may include:
- Physical therapy to improve strength, flexibility, balance, motor coordination and mobility
- Occupational therapy to develop everyday skills and to use adaptive products that help with everyday activities
- Speech therapy to relearn muscle control and coordination to produce speech
- Psychotherapy to learn coping strategies and new behavioral skills to improve mood disorders or address personality changes — with medication management if necessary.
- Encephalitis and meningitis fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm. Accessed March 8, 2011.
- Encephalitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec16/ch217/ch217c.html. Accessed March 10, 2011.
- Johnson RP, et al. Viral encephalitis in adults. http://www.uptodate.com/home/index.html. Accessed March 10, 2011.
- Hardarson HS. Acute viral encephalitis in children and adolescents: Clinical manifestations and diagnosis. http://www.uptodate.com/home/index.html. Accessed March 10, 2011.
- Beckham J, et al. Encephalitis. In: Mandell G, et al., eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2009. http://www.mdconsult.com/books/page.do?sid=1129246002&eid=4-u1.0-B978-0-443-06839-3..00087-4&isbn=978-0-443-06839-3&type=bookPage§ionEid=4-u1.0-B978-0-443-06839-3..00087-4&uniqId=237025740-4. Accessed March 10, 2011.
- Hardarson HS. Acute viral encephalitis in children and adolescents: Pathogenesis and etiology. http://www.uptodate.com/home/index.html. Accessed March 10, 2011.
- Information on arboviral enchephalitides. Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/dvbid/arbor/arbdet.htm. Accessed March 8, 2011.
- Hardarson HS. Acute viral encephalitis in children and adolescents: Treatment and prevention. http://www.uptodate.com/home/index.html. Accessed March 10, 2011.
- Insect repellant use and safety. Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/dvbid/westnile/qa/insect_repellent.htm. Accessed March 15, 2011.
- A parent's guide to insect repellent. American Academy of Pediatrics. http://patiented.aap.org/content.aspx?aid=5556. Accessed March 11, 2011.
- Acyclovir. National Center for Biotechnology Medicine. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000533. Accessed March 22, 2011.
- Ganciclovir injection. National Center for Biotechnology Medicine. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000889. Accessed March 22, 2011.
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